In observance of the Jewish Holiday of Sukkot, there will be no digest next Monday, October 17^th. The Digest will return on Monday October 24^th.

WHITE HOUSE:

The White House focused last week on the Administration’s ongoing response to Hurricane Ian, a new public-private partnership to increase investments in underserved and disadvantaged communities and the more information related to the Administration’s efforts to combat climate change (they created a central resource page). Two specific items of note for the industry:

• The President issued a mass pardon for anyone convicted of simple marijuana possession under federal law (~6,500 people). He also directed the federal government to review whether marijuana should continue to be classified as a Class I drug. The Washington Post has a good explainer on the immediate impact. Long-term, there will likely be ripple effects on everything from background/drug screening of healthcare employees to decriminalization at the state level to the commercial market related to marijuana. This is something to keep an eye on.

• They announced significant progress on their efforts to increase the supply of affordable housing. For our purposes, they finalized regulations related to Low Income Housing Tax Credit regulations, which makes several technical changes to the income guidelines that can increase those who qualify for affordable housing and whether buildings qualify for the credit. As this is something that can impact staff, as well as buildings near facilities, please consult with your tax advisors. You can access a copy of the regs here (PDF), which will go into effect upon publication to the federal register today (October 12^th, 2022).

CONGRESS:

With Congress out of office through the midterms, much of the talk has centered around what a post-Midterms Congress will look like, especially in a packed lame-duck session. A key point for the industry in those discussions will be the automatic Medicare PAYGO cuts scheduled to go into effect at the end of the year. In the meantime, the Congressional discussion is almost entirely focused on the midterms (and beyond):

• Politico took a look at the current state of discussion in DC around long-term care. None of the major proposals can pass Congress as-is, but the real issue is whether the Administration will incorporate elements into the upcoming minimum staffing bills and other CMS regulations.

• Senator Ben Sasse of Nebraska is expected to resign to take over the Presidency of the University of Florida. Nebraska Governor Pete Ricketts would then appoint a replacement, who’d serve out the rest of the term through 2024.

• The Hill, 538 and Politico all took a long look at the tightening Senate races in Wisconsin & Pennsylvania, key to control of the Senate after the Midterms.

• The Washington Post played out the different post-Midterm scenarios, including legislative agenda under each party’s control.

• Finally, Politico pointed out that even if the Democrats maintain control of the Senate in 2022, they face a very difficult 2024 map.

AGENCIES:

CMS held a national stakeholder call for SNF’s yesterday, outlining the return to normalcy that is slowly taking place. McKnight’s has a good summary.

With the many drug-related provisions in the Inflation Reduction Act, CMS released a fact sheet looking at the potential impact it will have on drug pricing. This information can help map out what to expect as the provisions start to come into effect. You can access a copy of the timeline (PDF) and the FAQ (PDF).

CMS also released the 2023 star ratings for MA plans, as well as a fact sheet outlining the technical changes that went into the ratings.

Finally, CMS issued a RFI asking for the public’s input as they explore creating a national director of healthcare providers. In theory, the directory would allow consumers to access more pertinent information across the entire spectrum of healthcare providers. You can submit a comment directly on the RFI page at the Federal Register.

Several other interesting items from federal agencies this week:

• The IRS awarded $41 million in “Tax Counseling for the Elderly (TCE) and Volunteer Income Tax Assistance (VITA)” grants to organizations who help the elderly file their taxes. You can access the complete list of awardees here (PDF). This may be of interest to your residents.

• The Department of Labor announced $80 million in funding to help address the shortage of nurses. This funding is aimed at public institutions (i.e. not specific facilities) to help train and expand the workforce. While not aimed specifically at facilities, there may be public-private partnerships available with grantees to build career pathways for staff. Full details are available here.

• AHRQ (the Agency for Healthcare Research & Quality) announced a challenge competition to identify ways for how to improve the integration of real-world data into the academic literature. This may be of interest to those of you involved with data platforms.

• Finally, the White House’s Office of Science & Technology Policy released a blueprint for an AI bill of rights. While non-binding, the idea is to start creating basic ethical standards governing the use of Artificial Intelligence. You can download a copy here (PDF).

MISCELLANEOUS:

• HealthAffairs explored the difference between the over-65 and under-65 populations in skilled nursing facilities and the need to create a different approach for the younger crowd.

• The Paragon Health Institute, a right-leaning think tank that focuses on free-market solutions to healthcare challenges, released the first of a two-part series focused on how the current system of Medicaid funding for LTC is causing the challenges inherent in the system. You can read the executive summary here (PDF) and the full report here (PDF).

• The American Journal of Infection Control reported a study that found wheelchair wheels and shoes are major sources of infection spread. While the study itself is behind a paywall, there’s a summary here.

• Modern Healthcare looked at how the staffing crisis at long term care facilities is causing backups and slowing discharges from hospitals. The article is behind a paywall.

• Kaiser Health News explored the disturbing trend of MA plans terminating SNF benefits before beneficiaries are well enough to go home.

• The TNA waiver expired on Friday, October 7^th. CMS issued several last minute approvals of state-wide waivers. McKnight’s has a good summary here.

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